Effects of Topical Tranexamic Acid in Immediate Prepectoral Breast Reconstruction PDF Download
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Author: Tyler Safran
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
"BACKGROUND:Breast cancer affects one in every eight women, the majority of whom will undergo treatment with mastectomy and implant-based breast reconstruction1. Excess fluid accumulation around the breast implant in the form of hematoma or seroma can lead to devastating complications including infection and capsular contracture. Although surgeons consistently strive for meticulous intra-operative hemostasis and place drains to minimize fluid collection, the reported rate of seroma and hematoma remains at 6.7% and 3.4%, respectively2. Topical administration of tranexamic acid (TXA), an antifibrinolytic agent, may reduce fluid accumulation and reduce the incidence of the aforementioned post-operative complications. The proposed paired, double-blind, randomized control trial aims to investigate if TXA treated breasts will exhibit less postoperative fluid production and secondarily decrease the incidence of hematoma, seroma, infection, and capsular contracture compared to placebo treatment.METHODS:This paired, double-blinded, randomized-controlled trial enrolled patients undergoing bilateral breast mastectomies with immediate reconstruction between January and July 2021. In each patient, one breast was randomized to receive 3g of in 70cc of normal saline, and the other received 100cc of normal saline alone. The blinded solutions were soaked in the mastectomy pocket for five minutes before implant placement. Postoperatively, daily drain outputs, complications, and baseline demographics were recorded.RESULTS:53 eligible patients, representing 106 breasts, were enrolled. All patients underwent bilateral nipple-sparing mastectomies. After randomization, TXA was placed in the right breast in 56.6% (n=30) of patients. The use of topical TXA resulted in a mean drain output reduction of 30.5% (RANGE: -83.6% - 26.6%). Drains on the TXA treated breast were eligible for removal 1.4(RANGE: 0-4) days sooner than the control side. TXA treated group had three complications (5.67%) versus 15 (28.3%) in the control group (Odds Ratio: 0.1920, p= 0.0129). Specifically, for operative hematomas, the TXA group had none(0%) versus three in the control group (5.7%)(Odds Ratio: 0.1348, P=0.18).CONCLUSION:In conclusion, soaking the mastectomy bed with 3% topical TXA before implant insertion leads to a decrease in drain output and a decrease in complications. Topical administration of TXA represents an option to decrease complications in breast reconstruction"--
Author: Tyler Safran
Publisher:
ISBN:
Category :
Languages : en
Pages : 0
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Book Description
"BACKGROUND:Breast cancer affects one in every eight women, the majority of whom will undergo treatment with mastectomy and implant-based breast reconstruction1. Excess fluid accumulation around the breast implant in the form of hematoma or seroma can lead to devastating complications including infection and capsular contracture. Although surgeons consistently strive for meticulous intra-operative hemostasis and place drains to minimize fluid collection, the reported rate of seroma and hematoma remains at 6.7% and 3.4%, respectively2. Topical administration of tranexamic acid (TXA), an antifibrinolytic agent, may reduce fluid accumulation and reduce the incidence of the aforementioned post-operative complications. The proposed paired, double-blind, randomized control trial aims to investigate if TXA treated breasts will exhibit less postoperative fluid production and secondarily decrease the incidence of hematoma, seroma, infection, and capsular contracture compared to placebo treatment.METHODS:This paired, double-blinded, randomized-controlled trial enrolled patients undergoing bilateral breast mastectomies with immediate reconstruction between January and July 2021. In each patient, one breast was randomized to receive 3g of in 70cc of normal saline, and the other received 100cc of normal saline alone. The blinded solutions were soaked in the mastectomy pocket for five minutes before implant placement. Postoperatively, daily drain outputs, complications, and baseline demographics were recorded.RESULTS:53 eligible patients, representing 106 breasts, were enrolled. All patients underwent bilateral nipple-sparing mastectomies. After randomization, TXA was placed in the right breast in 56.6% (n=30) of patients. The use of topical TXA resulted in a mean drain output reduction of 30.5% (RANGE: -83.6% - 26.6%). Drains on the TXA treated breast were eligible for removal 1.4(RANGE: 0-4) days sooner than the control side. TXA treated group had three complications (5.67%) versus 15 (28.3%) in the control group (Odds Ratio: 0.1920, p= 0.0129). Specifically, for operative hematomas, the TXA group had none(0%) versus three in the control group (5.7%)(Odds Ratio: 0.1348, P=0.18).CONCLUSION:In conclusion, soaking the mastectomy bed with 3% topical TXA before implant insertion leads to a decrease in drain output and a decrease in complications. Topical administration of TXA represents an option to decrease complications in breast reconstruction"--
Author: Linda S. Aglio
Publisher: Springer
ISBN: 3319501410
Category : Medical
Languages : en
Pages : 457
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Book Description
Divided into twelve sections that cover the entirety of anesthetic practice, this is a case-based, comprehensive review of anesthesiology that covers the basics of anesthetic management and reflects all new guidelines and recently developed standards of care. Each chapter of Anesthesiology: Clinical Case Reviews begins with a specific clinical problem or a clinical case scenario, followed by concise discussions of preoperative assessment, intraoperative management, and postoperative pain management. In addition to residents and fellows, this book is written for practicing anesthesiologists, student nurse anesthetists, and certified registered nurse anesthetists (CRNAs).
Author: Adriana Cordova
Publisher: Springer Nature
ISBN: 3030255026
Category : Medical
Languages : en
Pages : 166
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Book Description
The thorax has a fundamental role in the aesthetic of the male body: congenital or acquired alterations are experienced as extremely frustrating clinical situations. Most breast surgery texts briefly mention gynecomastia, but no text comprehensively addresses the male breast and thorax, including reconstructive and cosmetic surgery and surgery in transgender patients. This gap is now thoroughly filled by Plastic and Cosmetic Surgery of the Male Breast: after introducing principles of anatomy and aesthetics for the male thorax, the first part focusses on the main congenital malformations and their treatment; the main benign acquired pathologies and their treatment (including an ample section dedicated to gynecomastia), the carcinoma of the male breast, with reference to familiar forms; the treatment of carcinoma and reconstruction of the thorax. The book closes with a chapter dedicated to breast surgery in transgender patients. While female breast surgery is increasingly practiced in specific Breast Units and highly specialized centers, male breast issues are treated in general and plastic surgeries units. This handy volume is a sound reference for the most complex clinical cases, and the latest reconstruction treatments for the male thorax and will be useful for general and thoracic surgeons, plastic surgeons and senologists.
Author: Bruce E. Katz
Publisher: Saunders
ISBN:
Category : Medical
Languages : en
Pages : 224
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Book Description
Edited by leading authorities Bruce E. Katz and Neil S. Sadick, MD, Body Contouring is a brand-new volume in the Procedures in Cosmetic Dermatology Series. It showcases the hottest new body rejuvenation techniques and technologies, including laser lipolysis, focused ultrasound, mesotherapy, laser and light treatments, subcision for cellulite, and more. International contributions equip you to master the newest approaches from around the world. Succinctly written and lavishly illustrated, the book offers a wealth of pearls and pitfalls to help you refine your skills and avoid complications. A bonus DVD allows you to refine your skills by watching key techniques being performed by the authors. Shows you how to perform the hottest new techniques in body sculpting, including laser lipolysis, focused ultrasound, mesotherapy, laser and light treatments, subcision for cellulite, and more. Offers clinical pearls, pitfalls, and key points to help you get the best results for all procedures. Allows you to master the best and newest techniques and technologies from around the world, thanks to contributions from high-profile physicians with a wealth of international expertise. Includes a DVD that helps you learn key procedures by seeing them performed by the authors themselves.
Author: Jeffrey A. Klein
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 494
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Book Description
TUMESCENT TECHNIQUE is the definitive reference on all aspects of the tumescent technique of anesthesiology used in liposuction. Written by the inventor of the tumescent technique, this resource explains the pathophysiology, complications, pharmacology, and the different methods used to achieve great cosmetic results. Step-by-step instructions demonstrate how to perform this procedure on all areas of the body. Complications and postoperative care are also addressed. * Written by Dr. Klein, a leading expert in the field and the physician who invented and perfected the technique. * Provides step-by-step instructions for administering the local anesthesia with a practical, easy-to-follow approach. * Discusses tumescent liposuction techniques for each body region, addressing procedures, guidelines, and complications for each. * Covers complications and how to avoid them, preventing problems before they arise. * Provides detailed illustrations of techniques and before and after photographs to allow you to see expected results.
Author: Frederick A. Matsen
Publisher: Saunders
ISBN:
Category : Medical
Languages : en
Pages : 184
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Book Description
Author: Arnold Sturmdorf
Publisher:
ISBN:
Category : Generative organs, Female
Languages : en
Pages : 406
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Book Description
Author: James Chang
Publisher: Elsevier Health Sciences
ISBN: 0323568602
Category : Medical
Languages : en
Pages : 432
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Book Description
As the surgical community steps up to tackle the global burden of surgical disease in developing countries, Global Reconstructive Surgery is the first reference of its kind to offer focused, pertinent coverage of key areas surgeons need to understand to fully participate in this endeavor. It provides authoritative, real-world guidance on common surgeries performed around the world to help optimize outcomes in difficult environments and for a variety of conditions. Offers practical wisdom and experience from surgeons who have lived and worked in challenging global settings. The clear, organized format is based on the way clinicians examine, prepare for, and treat patients in resource-limited circumstances. Each chapter matches the clinical pathway and thought processes of care delivery, from the clinical problem and pre-operative assessment to operative intervention, post-operative care, and possible complications and options for management. Covers perioperative management, cleft and craniofacial surgery, hand surgery, burns, trauma, and key techniques commonly performed by surgeons across the globe. Includes the surgical steps of each procedure, photographs of clinical cases, and surgical pearls for resource-poor settings. Discusses alternative approaches related to cultural considerations and unavailability of state-of-the-art equipment. Ideal for plastic surgeons, otolaryngologists, craniofacial surgeons. oral and maxillofacial surgeons, general surgeons – both those who volunteer for surgical trips and those training in local communities.
Author: Sherrell J Aston
Publisher: Elsevier Health Sciences
ISBN: 0702054372
Category : Medical
Languages : en
Pages : 973
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Book Description
Aesthetic Plastic Surgery - edited by Sherrell J. Aston, MD, Douglas S. Steinbrech, MD and Jennifer L. Walden, MD - brings you the masterful expertise you need to achieve breathtaking outcomes for every cosmetic surgery procedure, including MACS lift, endoscopic mid and lower face rejuvenation, lid/cheek blending - the tear trough, cohesive gel breast augmentation, lipoabdominoplasty, and many more. A "who's who" of international authorities in plastic surgery explain their signature techniques, giving you all the know-how you need deliver the exceptional results your patients demand. Operative videos on DVD let you observe these techniques being performed in real time; and Expert Consult online access enables you to reference the text, download the images, and watch the videos from any computer. Coverage of hot topics includes MACS lift, endoscopic mid and lower face rejuvenation, lid/cheek blending - the tear trough, the newest rhinoplasty techniques, cohesive gel breast augmentation, fat grafting techniques, details of the latest injectables and fillers, and many other highly sought-after procedures. Operative videos - on DVD and online - let you see how leading experts perform more than 50 important techniques, including extended SMAS face lift, traditional inverted-T breast augmentation, and lipoabdominoplasty. Nearly 1600 full-color photographs and illustrations demonstrate what to look for and what results you will achieve. A consistent, extremely user-friendly organization guides you through history, evaluation, anatomy, technical steps, post-operative care, complications, and pearls and pitfalls for each procedure - giving you all the advice you need to make informed, effective decisions and avoid complications and disappointing results. Expert Consult online access allows you to reference the complete contents, perform rapid searches, download the images, and watch the operative videos from any computer. Your purchase entitles you to access the web site until the next edition is published, or until the current edition is no longer offered for sale by Elsevier, whichever occurs first. If the next edition is published less than one year after your purchase, you will be entitled to online access for one year from your date of purchase. Elsevier reserves the right to offer a suitable replacement product (such as a downloadable or CD-ROM-based electronic version) should online access to the web site be discontinued.
Author: Albert Losken
Publisher: Thieme
ISBN: 1638535094
Category : Medical
Languages : en
Pages : 822
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Book Description
FOUR STARS from Doody's Star Ratings™ This second edition of Partial Breast Reconstruction: Techniques in Oncoplastic Surgery builds on and expands the authoritative procedures presented in the first edition, adding and updating the content with up-to-the-minute concepts, techniques, and innovations in oncoplastic breast surgery, all elucidated with hundreds of color images and illustrations. This edition offers readers the following: A breadth of topics presented by internationally recognized experts from a range of disciplines from the U.S., Europe, United Kingdom, and South America A systematic chapter structure that provides patient presentation, workup, surgical techniques, and follow-up for each approach Emphasis on the essential contributions of all members of the multidisciplinary team Extensive coverage of oncologic principles, indications, psychological considerations/body image, the challenges of radiotherapy, and postoperative surveillance Prevention and correction of BCT deformities Exploration of the risks and benefits of delayed versus immediate reconstruction Reduction and mastopexy techniques with parenchyma autoaugmentation, central defect reconstruction, fat grafting, and local and perforator flap reconstruction techniques Outcomes presented as the ultimate proof of the validity of each technique, with long-term follow-up Treatment of complications Provided in both printed and e-book formats, with multiple videos of techniques As the oncoplastic approach to partial breast reconstruction continues to grow exponentially in popularity as a reliable treatment option, the updated information provided in this comprehensive new edition is absolutely essential to every surgeon performing partial breast reconstruction for women with breast cancer.
